PROJECT SUMMARY/ABSTRACT Candidate: The candidate?s training and fellowships have provided an excellent foundation in biobehavioral nursing science. To date, the candidate?s training has focused primarily on the neurobiology of sleep, as well as sleep assessment in the research setting. The primary purpose of this career development award is to expedite the candidate?s development into an independent nurse scientist with expertise in interventional sleep research. The K01 training goals include: 1) develop expertise in behavioral sleep interventions for adolescents with neurodevelopmental disorders (NDDs); 2) obtain training in adaptive intervention research designs; and 3) further develop skills in grantsmanship for interdisciplinary clinical translational research. Environment: The University of Nebraska Medical Center (UNMC) is a premier academic medical center with an affiliated hospital and clinics across campus that encourages collaboration across disciplines for education and research. The candidate has established a strong mentoring team at UNMC with highly qualified clinicians and researchers in the fields of developmental medicine, nursing, and sleep. Research: The objective of this K01 research proposal is to pilot a sequential, multiple assignment, randomized trial (SMART) design to compare the impact of a sequence of sleep interventions, based on participant treatment response, to optimize sleep health in adolescents 10-18 years of with NDDs. Sleep interventions will include melatonin, a novel behavioral sleep intervention (The Bedtime Bank), and their combination. This pilot study will inform implementation of a future full-scale SMART design. The proposed study is a critical first step in developing decision guidelines regarding the use of melatonin and behavioral sleep interventions to manage sleep disturbances in adolescents with NDDs. The proposed career development award will provide the necessary training to expedite the candidate?s development into an independent tenure-track investigator with expertise in sleep interventions for adolescents at risk for sleep disturbances. Long-term research goals are to 1) contribute to evidence-based guidelines for sleep interventions for children and adolescents with NDDs; 2) further explore the interaction between sleep-related phenotypes, biology, and genetics in children and adolescents at-risk for sleep disturbances; and 3) translate evidence-based sleep interventions from research to clinical practice and public health initiatives. Subsequent studies include an R01 application to be submitted in Year 3 of the award to conduct a full-scale SMART design, including examination of genetic variations potentially contributing to sleep disturbances in NDDs, and potential adaptation of the sleep interventions to additional pediatric populations at-risk for sleep disturbances. This application addresses NINR?s strategic plan, including innovative questions related to understanding the biological and behavioral dynamics of symptoms (e.g., sleep disturbance), and using innovative research methods (e.g., SMARTs) to improve symptom management and change the chronic illness trajectory.